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Outcomes With Plug-Based Versus Suture-Based Vascular Closure Device After Transfemoral Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Clinical Trials
Session:
SESSÃO DE POSTERS 05 - TAVI 1
Speaker:
Capela António Dicazeco Pascoal
Congress:
CPC 2025
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.1 Invasive Imaging and Functional Assessment
Session Type:
Cartazes
FP Number:
---
Authors:
Capela Pascoal; Ocilio Gonçalves; Hilária Faria; Barbara Masiero; Mohamed Doma; Antonino Francisco; Giovana Faria; Lucas Bendaham; Lorena Bahia; Mauer Gonçalves; Shirley Enríquez
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Background:</strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"> </span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#0d0d0d"><span style="background-color:#ffffff">Mixed results have been obtained in studies comparing </span></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#212121"><span style="background-color:#ffffff">plug-based (MANTA) with suture-based (ProStar XL and ProGlide) vascular closure devices (VCDs)</span></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#0d0d0d"><span style="background-color:#ffffff"> for closing large-caliber access after transcatheter aortic valve replacement (TAVR).</span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Question:</strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#0d0d0d"><span style="background-color:#ffffff"> Are plug-based vascular closure devices superior to suture-based devices in terms of adverse cardiovascular events in patients undergoing TAVR?</span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Methods: </strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">PubMed, Scopus and Cochrane database were searched for randomized controlled trials that compared MANTA with </span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><span style="background-color:#ffffff">ProStar XL or ProGlide </span></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#0d0d0d"><span style="background-color:#ffffff">for closing large-caliber access after TAVR </span></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">and reported the outcomes of (1) major vascular complications; (2) minor vascular complications; (3) major or minor bleeding; and (4) life threatening bleed. Heterogeneity was examined with I</span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><sup>2</sup></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"> statistics. A random-effects model was used for outcomes with high heterogeneity. </span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Results: </strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">We included 4 RCTs with 717 patients, of whom 358 (49.9%) underwent MANTA. Major vascular complication (RR 1.70; 95% CI 0.91 - 3.15; p = 0.10; <strong>Figure 1a</strong>), minor vascular complication (RR 1.10; 95% CI 0.63 - 1.92; p = 0.73), major bleeding (RR 0.45; 95% CI 0.72 - 2.92; p = 0.30; <strong>Figure 1b</strong>) and life threatening bleed (RR 1.37; 95% CI 0.52 - 3.61; p = 0.52; <strong>Figure 1c</strong>) was not significantly different between plug-based VDC and suture-based VDC. </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Conclusion: </strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#212121"><span style="background-color:#ffffff">The vascular closure devices plug-based are a safe and feasible option for vascular access closure in patients undergoing transfemoral TAVR.</span></span></span></span></p>
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